Åse Marie Hansen

Collection of domestic waste. Review of occupational health problems and their possible causes.

During the last decade, a growing interest in recycling of domestic waste has emerged, and action plans to increase the recycling of domestic waste have been agreed by many governments. A common feature of these plans is the implementation of new systems and equipment for the collection of domestic waste which has been separated at source. However, only limited information exists on possible occupational health problems related to such new systems. Occupational accidents are very frequent among waste collectors. Based on current knowledge, it appears that the risk factors should be considered as an integrated entity, i.e. technical factors (poor accessibility to the waste, design of equipment) may act in concert with high working rate, visual fatigue due to poor illumination and perhaps muscle fatigue due to high work load. Musculoskeletal problems are also common among waste collectors. A good deal of knowledge has accumulated on mechanical load on the spine and energetic load on the cardio-pulmonary system in relation to the handling of waste bags, bins, domestic containers and large containers. However, epidemiologic studies with exposure classification based on field measurement are needed, both to further identify high risk work conditions and to provide a detailed basis for the establishment of occupational exposure limits for mechanical and energetic load particularly in relation to pulling, pushing and tilting of containers. In 1975, an excess risk for chronic bronchitis was reported for waste collectors in Geneva (Rufèner-Press et al., 1975) and data from the Danish Registry of Occupational Accidents and Diseases also indicate an excess risk for pulmonary problems among waste collectors compared with the total work force. Surprisingly few measurements of potentially hazardous airborne exposures have been performed, and the causality of work-related pulmonary problems among waste collectors is unknown. Recent studies have indicated that implementation of some new waste collection systems may result in an increased risk of occupational health problems. High incidence rates of gastrointestinal problems, irritation of the eye and skin, and perhaps symptoms of organic dust toxic syndrome (influenza-like symptoms, cough, muscle pains, fever, fatigue, headache) have been reported among workers collecting the biodegradable fraction of domestic waste. The few data available on exposure to bio-aerosols and volatile compounds have indicated that these waste collectors may be simultaneously exposed to multiple agents such as dust containing bacteria, endotoxin, mould spores, glucans, volatile organic compounds, and diesel exhaust. Several studies have reported similar health problems as well as high incidence rates of pulmonary disease among workers at plants recycling domestic waste.(ABSTRACT TRUNCATED AT 400 WORDS)

Long-term stability of salivary cortisol

The measurement of salivary cortisol provides a simple, non‐invasive, and stress‐free measure frequently used in studies of the hypothalamic‐pituitary‐adrenal axis activity. In research projects, samples are often required to be stored for longer periods of time either because of the protocol of the project or because of lack of funding for analysis. The aim of the present study was to explore the effects of long‐term storage of samples on the amounts of measurable cortisol. Ten pools of saliva were collected on polyester Salivette® tampons from five subjects. After centrifugation the samples were either stored in small vials or spiked to polyester Salivette tampons before analysis for cortisol using Spectria RIA kits. The effects of storage were evaluated by a linear regression model (mixed procedure) on a logarithmic scale. No effects on cortisol concentrations were found after storage of saliva at 5°C for up to 3 months or at −20°C and −80°C for up to one year. In contrast, concentrations of cortisol were found to decrease by 9.2% (95% confidence interval (CI): 3.8%; 14.3%) per month in samples stored at room temperature. Repeated freezing and thawing of samples up to four times before analysis did not affect the measured concentrations of cortisol. The coefficient of residual variation (CVresid) for samples stored on Salivette tampons were twice the CVresid for samples stored in separate vials after centrifugation. In conclusion, centrifuged saliva samples for analysis of cortisol may be stored at 5°C for up to 3 months or at −20°C or −80°C for at least one year. However, long‐term storage at room temperature cannot be recommended. Repeated cycles of freezing and thawing did not appear to affect the concentrations of cortisol.

Sorting and recycling of domestic waste. Review of occupational health problems and their possible causes

In order to reduce the strain on the environment from the deposition of waste in landfills and combustion at incineration plants, several governments throughout the industrialized world have planned greatly increased recycling of domestic waste by the turn of the millennium. To implement the plans, new waste recycling facilities are to be built and the number of workers involved in waste sorting and recycling will increase steadily during the next decade. Several studies have reinforced the hypothesis that exposure to airborne microorganisms and the toxic products thereof are important factors causing a multitude of health problems among workers at waste sorting and recycling plants. Workers at transfer stations, landfills and incineration plants may experience an increased risk of pulmonary disorders and gastrointestinal problems. High concentrations of total airborne dust, bacteria, faecal coliform bacteria and fungal spores have been reported. The concentrations are considered to be sufficiently high to cause adverse health effects. In addition, a high incidence of lower back injuries, probably due to heavy lifting during work, has been reported among workers at landfills and incineration plants. Workers involved in manual sorting of unseparated domestic waste, as well as workers at compost plants experience more or less frequent symptoms of organic dust toxic syndrome (ODTS) (cough, chest-tightness, dyspnoea, influenza-like symptoms such as chills, fever, muscle ache, joint pain, fatigue and headache), gastrointestinal problems such as nausea and diarrhoea, irritation of the skin, eye and mucous membranes of the nose and upper airways, etc. In addition cases of severe occupational pulmonary diseases (asthma, alveolitis, bronchitis) have been reported. Manual sorting of unseparated domestic waste may be associated with exposures to large quantities of airborne bacteria and endotoxin. Several work functions in compost plants can result in very high exposure to airborne fungal spores and thermophilic actinomycetes. At plants sorting separated domestic waste, e.g. the combustible fraction of waste composed of paper, cardboard and plastics, the workers may have an increased risk of gastrointestinal symptoms and irritation of the eyes and skin. At such plants the bioaerosol exposure levels are in general low, but at some work tasks, e.g. manual sorting and work near the balers, exposure levels may occasionally be high enough to be potentially harmful. Workers handling the source-sorted paper or cardboard fraction do not appear to have an elevated risk of occupational health problems related to bioaerosol exposure, and the bioaerosol exposure is generally low.(ABSTRACT TRUNCATED AT 400 WORDS)

Evaluation of a radioimmunoassay and establishment of a reference interval for salivary cortisol in healthy subjects in Denmark

A commercial radioimmunoassay (RA) for salivary cortisol was evaluated using certified reference material in water and spiked to pooled saliva in the range 2.1–89.1u2005nmol/L. A variance component model for describing the effects of age, body mass index (BMI), diurnal variation, gender, days of sick leave during the past year, and smoking habits was established. Reference intervals for salivary cortisol in 120 healthy individuals performing their routine work were established according to the International Union of Pure and Applied Chemistry (IUPAC) and the International Federation of Clinical Chemistry (IFCC). The method evaluation of the certified reference material in water did not show any bias of the method, i.e. recovery was 97% [CI: 94%; 100.9%]. LOD (detection limit) was 1.59u2005nmol/L. The ratio between analytical and within‐subject variation (CVa/CVi) was 0.14, indicating that the method was adequate for measurement in healthy subjects. Reference intervals were estimated to be from 3.6 to 35.1u2005nmol/L for samples at the time of awakening (05.27–07.27), 7.6–39.4u2005nmol/L for peak level in saliva samples collected 20u2005min after awakening (05.47–07.47), and LOD 10.3u2005nmol/L for late afternoon samples (17.00–19.00). Reactivity (increase from awakening to 20u2005min after awakening) was estimated to be 82% [CI: −179; 345%] and recovery (decrease from 20u2005min after awakening to 18.00) to be 80% [CI: 51; 109%]. Eighteen percent of the subjects showed a decrease in cortisol in saliva from awakening to 20u2005min after awakening. Salivary cortisol was not affected by age, body mass index, gender, smoking habits or days of sick leave during the past year.

Analytical methods for determining urinary catecholamines in healthy subjects

Objective: To perform a critical review of analytical methods for urinary catecholamines based on method performance parameters, such as analytical range, limit of detection (LOD), robustness, and the applicability for assessment of stress effects in urine from healthy subjects. n nMethod: Five criteria were chosen for rating the analytical methods. The score value should give an indication of the usefulness of the method for measurement of catecholamines in urine from healthy subjects. The maximum score for a paper is ‘5’, and one point is given for each of the following. n1. nAnalytical range must start at 7xa0nmol/l or below. n n2. nLOD (or limit of quantification (LOQ)) <7xa0nmol/l for both adrenaline (A) and noradrenaline (NA). n n3. nSome precision parameters have been described (i.e. repeatability and/or reproducibility). n n4. nUrine samples were analysed. n n5. nThe method is fully automated method (i.e. clean-up procedure included in system). n n n n nResults: A total of 7, out of 28 papers rated score the maximum of ‘5’, and 5 papers score ‘4’; these are all high performance liquid chromatographic (HPLC) methods. The scores of the remaining 16 papers are distributed as follows: 10 papers score ‘3’, 4 papers score ‘2’ and 2 papers score ‘1’. n nConclusion: The literature review has shown that automated HPLC systems still are the most applicable and well-documented methods for the analysis of A and NA in urine. Some quality parameters were summarised, and it was shown that many of the papers lack valuable information. It is recommended that future papers validate the method described and report the necessary quality parameters such as LOD, analytical range, precision, etc.

Seasonal and biological variation of urinary epinephrine, norepinephrine, and cortisol in healthy women.

BACKGROUNDnThere is a significant circadian and seasonal periodicity in various endocrine functions. The present study describes the within-day and seasonal fluctuation for urinary catecholamines and cortisol and estimates the within- (CV(i)) and between-subject (CV(g)) coefficients of variation for healthy women undertaking their routine work. In addition, index of individuality (I(i)) and power calculations were derived.nnnMETHODSnEleven healthy females undertaking their routine life-style at work participated in the study. Each subject collected six samples during 24 h 15 days over a year, giving a total number of 990 samples. Using a random effect analysis of variance, we estimated CV(g) and total within-subject variation (CV(ti)), i.e. combined within-subject and analytical variation, from logarithmically transformed data. Analytical variation was subtracted from CV(ti) to give CV(i). CV(i) was estimated from samples collected monthly during 1 year (CV(iy)), weekly during 1 month (CV(im)), and six to eight times/day (CV(id)).nnnRESULTSnA seasonal variation was demonstrated for excretion of epinephrine, norepinephrine, and cortisol standardized with creatinine. Concentrations of urinary epinephrine were higher during June and July compared to the rest of the year, whereas concentrations of urinary cortisol were higher during December and January compared to the rest of the year. Excretion of norepinephrine was lower during working hours and higher during hours off work for June and July compared to the rest of the year. There was a high within- and between-subject variation, which could not be explained by menstrual cycle, behavioral, emotional, or cognitive stress reactions.nnnCONCLUSIONSnDespite high biological variation a reasonably low sample size, e.g. 10-50 individuals, is adequate for practical applicability, i.e. studying differences above 150%. The present study recommends to include the sampling time in the statistical evaluation of data and to be aware of the changes in diurnal variations over seasons. When single measurements are to be evaluated, reference intervals are recommended.

Correlation between work process-related exposure to polycyclic aromatic hydrocarbons and urinary levels of α-naphthol, β-naphthylamine and 1-hydroxypyrene in iron foundry workers

SummaryIn two Danish iron foundries the concentration of polycyclic aromatic hydrocarbons (PAH) in 24 personal air samples of workers employed in selected processes, i.e. melters, melted iron transporters, casters, machine molders, hand molders, shake-out workers and finishing workers, were measured and correlated to levels of 1-hydroxypyrene, α-naphthol and β-naphthylamine in the urine of exposed workers. The highest total airborne PAH concentrations (sum of 15 selected PAH compounds: 9.6–11.2 μg/m3) were associated with casting, machine molding, and shake-out. The highest concentrations of the sum of six selected airborne carcinogenic PAH compounds were found for melting, casting and machine and hand molding. As seen in other working environments involving low-level PAH exposure, the content of naphthalene was high, in general exceeding 85% of the total content of PAH compounds. The present study demonstrates that 1-hydroxypyrene is a useful and direct biomarker of low-dose occupational exposure to PAH compounds. Molding and casting had the highest pyrene levels in iron foundries. Furthermore, the data shows that levels of β-naphthylamine in urine are significantly elevated in iron foundry workers. Hand molders, finishing workers and truck drivers tended to have the highest levels. Concerning α-naphthol the highest concentrations were measured in urine from casters and shake-out workers. With regard to epidemiologic studies demonstrating that molders and casters have a higher risk of lung cancer, the present study suggests that the elevated risk may be due to exposure to carcinogenic PAH compounds in iron foundries, particularly in some high-risk work processes, e.g. casting and molding. In addition, the present study suggests that biological monitoring of 1-hydroxypyrene and β-naphthylamine may be used to estimate the individual exposure, which seems to be correlated with exposure during individual work processes.

Diurnal Urinary 6‐Sulfatoxymelatonin Levels among Healthy Danish Nurses during Work and Leisure Time

The present study aims to examine the influence of evening and night shift work, compared to day shift work, on melatonin secretion in nurses in a field setting. Effects were examined during a workday and during a day off. Both fixed schedules and mixed or rotating schedules were studied. In total, 170 nurses were studied: 89 nurses worked fixed schedules, 27 nurses worked the day shift, 12 nurses worked the evening shift, 50 nurses worked the night shift, and 82 nurses worked mixed schedules, with data collected during a day (n=17), evening (n=14), or night shift (n=50). All spot urine samples were collected during 24 h from the participants on a work day and on a day off and were analyzed for 6‐sulphatoxymelatonin. On the day of urine sampling, participants filled in the Karolinska Sleep Diary. Additional information was collected through a telephone interview. Data were analyzed using a mixed procedure with autoregressive covariance structure. The present study showed that shift work affected the concentrations of 6‐sulphatoxymelatonin in the short term by lower excretion in urine from nurses working the night compared to day shift on a workday and on a day off as well. No significant differences were observed between a workday and a day off when doing day and evening shifts, irrespective of mixed and fixed schedules. Sleep length was reduced workdays (from 6.1–6.8 h) among all nurses, compared to days off (from 7.8–8.7 h).

Quantifying catecholamines using multi-way kinetic modelling

Abstract A new method for quantifying adrenaline and noradrenaline concentrations from mixtures of catecholamine standards is described. The method derives selectivity from the different rates, at which the fluorescing 3,5,6-trihydroxyindole derivatives (lutines) of the catecholamines are formed and degraded for adrenaline and noradrenaline. The standards used had the concentration ranges 50–1200xa0nmol/l for adrenaline and 30–1400xa0nmol/l for noradrenaline. Fluorescence landscapes were measured at consecutive time points for every sample hereby creating a four-way data array. It is shown that the raw dataset can be dramatically reduced in size without loosing significant information hereby making calculations much faster and lessening instrumental performance requirements. The data follow a two-component four-way parallel factor analysis model (PARAFAC), from which quantitative information is also obtained. Two-component multilinear partial least squares regression (N-PLSR) was also employed for the quantification of the catecholamines. The results for PARAFAC and N-PLSR were very similar with root mean squared errors of cross-validation (RMSECV) being in the range 24–30xa0nmol/l. Several improvements of the method are suggested, and it is expected that the method will be suitable for determination of catecholamines in urine from healthy subjects.

Validation of a high performance liquid chromatography analysis for the determination of noradrenaline and adrenaline in human urine with an on-line sample purification

A high performance liquid chromatography (HPLC) method with fluorescence detection including an on-line purification was established for determination of catecholamines in human urine. The method was evaluated using samples of pooled urine spiked with catecholamines and validated for measurements of catecholamines in urine of healthy individuals in a field study. The laboratory method evaluation study showed that the recovery of the method was 0.82 (confidence interval (CI): 0.79-0.86) and 0.92 (CI: 0.89-0.95) for noradrenaline and adrenaline, respectively. Thus, correction factors of 0.82(-1) and 0.92(-1) were applied to correct the measurement results for this systematic effect. Furthermore, an uncertainty budget was generated for the analytical method using the BIPM-approach recommended by the International Organization for Standardization. The relative uncertainty of the method was estimated to be 10-12%, which was consistent with the observed relative variability found in the method evaluation. The method was evaluated in accordance with EURACHEM Guidance Document No 1 concerning accreditation for chemical laboratories with respect to accuracy and precision. The field study showed that the standard deviation of the method was sufficiently low to distinguish between persons working with two different processes of garbage collection, i.e. collection using four wheeled containers versus collection using bins.